HomeMy WebLinkAboutSystems Report 4/22/2009
MJNNESOTA CONWAY
'3T4WEST 86TH STREET, SUITE 101
BLOOMINGTON, MN 55420
952-345-FIRE · FAX 952-345-2499
No. PE 76379
PRE ENGINEERED SYSTEMS REPORT
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PHONE
SERVICE
ADDRESS
PURCHASE ORDER #
CONTACT
SITE #
AUTHORIZED BY
MASTER CYL 3, ro SLAVE CYL SLAVE CYL
360 LINK I 450 LINK 500 LINK OTHER
WET CHE~ DRY CHEM FUEL SH~F ELECTRIK GAS ~ SIZE
Y N CO2 OTHER SERIAL # LAST HYDRO TEST DATE LAST RECHARGE DATE
INSPECTION CHECK LIST
1. ALL APPLIANCES PROPERLY COVERED w/CORRECr IJOZZLES ~ 14. CHECK OPERATION OF MICRO SWITCH /
2. DUCT AND PLENUM COVERED w/CORRECT NOZZLES 15. CHECK OPERATION OF GAS VALVE /'
3. CHECK POSITIONING OF ALL NOZZLES .,/ 16. CLEAN NOZZLES .-
4. SYSTEM INSTALLED IN ACCORDANCE w/MFG UL LISTING /' 17. PROPER NOZZLE COVERS IN PLACE ./'
5. HOOD/DUCT PENETRATIONS SEALED wlWELD OR UL DEVICE V 18. CHECK FUSE LINKS AND CLEAN ."...-
6. IF SYSTEM HAS BEEN DISCHARGED, REPORT SAME "./' 19. REPLACED FUSE LINKS ./'
7. PRESSURE GAUGE IN PROPER RANGE (IF GAUGED) /' 20. PIPING AND CONDUIT SECURELY BRACKETED /'
8. CHECK CARTRIDGE WEIGHT (IF APPLICABLE) ./ 21. PROPER SEPARATION BETWEEN FRYERS AND FLAME N( ~
9. HYDROSTATIC TEST DATE /- 22. EXHAUST FAN IN OPERATING ORDER -
10. 6-YEAR MAINTENANCE DATE ./ 23. FUEL SHUT-OFF IN ON POSITION -"
11. INSPECT CYLINDER AND MOUNT ~. 24. MANUAL AND REMOTE SET/SEALS IN PLACE .,.-
12. OPERATE SYSTEM FROM TERMINAL LINK 25. SLAVE SYSTEM OPERATIONAL ~~
13. TEST FOR PROPER OPERATION FROM REMOTE ./ 26. SERVICE AND CERTIFICATION TAG ON SYSTEM ~
SYSTEM DEFICIENCIES
1. IMPROPER INSTALLATION/MISAPPLICATION
2. FUEL SHUT-OFF OR ELECTRICAL DISCONNECT REQUIRED
5. OTHER
3. ADDITIONAL PROTECTION REQUIRED
4. VENTILATION SYSTEM NEEDS CLEANING/REPAIR
RECHG
HYDRO
6YR
SERV
DESCRIPTION
UNIT PRICE AMOUNT'
WET CHEM
LB DRY CHEM
LB DRY CHEM
LB DRY CHEM
LB DRY CHEM
LB C02
LB C02
WET CHEM SY~
REGD
REGD
REGD
REGD
ABCD
ABCD
ABCD
ABCD
PK/SK D
PK/SK D
PK/SK D
PK/SK 0
I
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DESCRIPTION
SERVICE CALL
UNIT PRICE
DRY CHEM SYS D
ORDERED SHIPPED
SERVICE TECHNf
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TOTAL SERVICE $ I 0
TOTAL MATERIALS $ (C. (j"
STATE SALES TAX $
SHIPPING &. HANDLING $
GRAND TOTAL $
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CUSTOMER SIGNATUR
NOTICE: A COPY OF THIS REPORT MAY BE ENT T OCAL FIRE
MARSHAL WHEN REQUIRED BY AUTHORITY HAVING JURISDICTION